A European Renal Best Practice (ERBP) position statement on the Kidney Disease Improving Global Outcomes (KDIGO) Clinical Practice Guidelines on Acute Kidney Injury: Part 1: definitions, conservative management and contrast-induced nephropathy

Fliser, Danilo; Laville, Maurice; Covic, Adrian; Fouque, Denis; Vanholder, Raymond; Juillard, Laurent; Biesen, Wim Van

doi:10.1093/ndt/gfs375

Cited by 479 publications

(258 citation statements)

References 72 publications

Supporting

Mentioning

227

Contrasting

Unclassified

Order By: Relevance

“…Furthermore, although we adjusted for the main nephrotoxic agents (e.g., contrast media and antimicrobial agents), we must acknowledge the lack of information regarding other nephrotoxic agents, such as angiotensin-converting enzyme inhibitors or angiotensin receptor antagonists. In this study, and in accordance with current guidelines, baseline creatinine was back calculated from the MDRD assuming a 75 ml/kg per 1.73 m 2 GFR (35,47). Although this imputation was validated in previous works (48), it may overestimate the incidence of AKI by nearly 10% and may misclassify severity of AKI in up to 30% (49).…”

Section: Discussionmentioning

confidence: 99%

Acute Respiratory Distress Syndrome and Risk of AKI among Critically Ill Patients

Darmon¹,

Clec’h²,

Adrie³

et al. 2014

Clinical Journal of the American Society of Nephrology

170

159

View full text Add to dashboard Cite

Background and objectives Increasing experimental evidence suggests that acute respiratory distress syndrome (ARDS) may promote AKI. The primary objective of this study was to assess ARDS as a risk factor for AKI in critically ill patients.Design, setting, participants, & measurements This was an observational study on a prospective database fed by 18 intensive care units (ICUs). Patients with ICU stays .24 hours were enrolled over a 14-year period. ARDS was defined using the Berlin criteria and AKI was defined using the Risk, Injury, Failure, Loss of kidney function, and End-stage kidney disease criteria. Patients with AKI before ARDS onset were excluded.Results This study enrolled 8029 patients, including 1879 patients with ARDS. AKI occurred in 31.3% of patients and was more common in patients with ARDS (44.3% versus 27.4% in patients without ARDS; P,0.001). After adjustment for confounders, both mechanical ventilation without ARDS (odds ratio [OR], 4.34; 95% confidence interval [95% CI], 3.71 to 5.10) and ARDS (OR, 11.01; 95% CI, 6.83 to 17.73) were independently associated with AKI. Hospital mortality was 14.2% (n=1140) and was higher in patients with ARDS (27.9% versus 10.0% in patients without ARDS; P,0.001) and in patients with AKI (27.6% versus 8.1% in those without AKI; P,0.001). AKI was associated with higher mortality in patients with ARDS (42.3% versus 20.2%; P,0.001).Conclusions ARDS was independently associated with AKI. This study suggests that ARDS should be considered as a risk factor for AKI in critically ill patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Acute Respiratory Distress Syndrome and Risk of AKI among Critically Ill Patients

Darmon¹,

Clec’h²,

Adrie³

et al. 2014

Clinical Journal of the American Society of Nephrology

170

159

View full text Add to dashboard Cite

show abstract

“…Finally, in 2012, the Kidney Disease Improving Global Outcomes (KDIGO) Work Group proposed another definition that builds upon the AKIN definition (18). The KDIGO definition has been adopted by the Renal Association of the United Kingdom (19) and has been the subject of commentary by other professional societies from the United States (20), Europe (21), and Canada (22).…”

Section: Introductionmentioning

confidence: 99%

Incidence, Outcomes, and Comparisons across Definitions of AKI in Hospitalized Individuals

Zeng

McMahon

Brunelli³

et al. 2014

Clinical Journal of the American Society of Nephrology

376

258

View full text Add to dashboard Cite

SummaryBackground and objectives At least four definitions of AKI have recently been proposed. This study sought to characterize the epidemiology of AKI according to the most recent consensus definition proposed by the Kidney Disease Improving Global Outcomes (KDIGO) Work Group, and to compare it with three other definitions.Design, setting, participants, & measurements This was a retrospective cohort study of 31,970 hospitalizations at an academic medical center in 2010. AKI was defined and staged according to KDIGO criteria, the Acute Dialysis Quality Initiative's RIFLE criteria, the Acute Kidney Injury Network (AKIN) criteria, and a definition based on a model of creatinine kinetics (CK). Outcomes of interest were incidence, in-hospital mortality, length of stay, costs, readmission rates, and posthospitalization disposition.Results AKI incidence was highest according to the KDIGO definition (18.3%) followed by the AKIN (16.6%), RIFLE (16.1%), and CK (7.0%) definitions. AKI incidence appeared markedly higher in those with low baseline serum creatinine according to the KDIGO, AKIN, and RIFLE definitions, in which AKI may be defined by a 50% increase over baseline. AKI according to all definitions was associated with a significantly higher risk of death and higher resource utilization. The adjusted odds ratios for in-hospital mortality in those with AKI were highest with the CK definition (5.2; 95% confidence interval [95% CI], 4.1 to 6.6), followed by the RIFLE (2.9; 95% CI, 2.2 to 3.6), KDIGO (2.8; 95% CI, 2.2 to 3.6), and AKIN (2.6; 95% CI, 2.0 to 3.3) definitions. Concordance in diagnosis and staging was high among the KDIGO, AKIN, and RIFLE definitions. ConclusionsThe incidence of AKI in hospitalized individuals varies depending on the definition used. AKI according to all definitions is associated with higher in-hospital mortality and resource utilization. AKI may be inappropriately diagnosed in those with low baseline serum creatinine using definitions that incorporate percentage increases over baseline.

show abstract

“…O termo Lesão Renal Aguda (LRA) é utilizado para refletir todo o espectro de Insuficiência Renal Aguda (IRA), reconhecendo que um declínio agudo da função renal é frequentemente secundário a uma lesão que provoca alterações funcionais ou estruturais nos rins (1) . Diante dos avanços tecnológicos, do aumento da sobrevida da população e da sofisticação da terapêutica, a LRA ainda é uma das complicações mais frequentes encontradas na Unidade de Terapia Intensiva (UTI).…”

Section: Introductionunclassified

Lesão Renal Aguda Em Unidade De Tratamento Intensivo: Características Clínicas E Desfechos

Luft¹,

Böes²,

Lazzari³

et al. 2016

Cogitare Enferm.

View full text Add to dashboard Cite

RESUMO: Estudo quantitativo, documental, retrospectivo, que objetivou caracterizar o perfil clínico-demográfico e o desfecho de pacientes com insuficiência renal, submetidos à terapia dialítica em uma unidade de terapia intensiva adulto de um hospital geral da região sul do Brasil. Os dados foram coletados no período de janeiro a fevereiro de 2013 e a amostra, constituída por 74 prontuários. Identificou-se prevalência do sexo masculino, média de 63,43 ± 14,73 anos, o motivo clínico foi o mais frequente para internação, com uma ou mais comorbidades associadas. A lesão renal com maior prevalência foi a crônica agudizada, pré-renal. CHRONIC KIDNEY INJURY AT AN INTENSIVE CARE SERVICE: CLINICAL CHARACTERISTICS AND OUTCOMES ABSTRACT:The objective in this quantitative and retrospective documentary study was to characterize the clinical-demographic profile and outcome of kidney failure patients submitted to dialysis therapy at an adult intensive care unit of a general hospital in the South of Brazil. The data were collected between January and February 2013 and the sample consisted of 74 patient histories. The prevalence of men was identified, with a mean age of 63.43 ± 14.73 years, clinical motives were the most frequent cause of hospitalization and one or more associated comorbidities. The most prevalent kidney injury was acute chronic, pre-renal injury. The most recurrent motive for the injury was septic shock. The preferred treatment was conventional hemodialysis using a catheter. The most common outcome was death. The, the identification of risk factors and knowledge about the associated factors supports the rapid identification of problems and the implementation of nursing actions. DESCRIPTORS: Inpatients; Renal insufficiency; Critical care; Renal dialysis. LESIÓN RENAL AGUDA EN UNIDAD DE TRATAMIENTO INTENSIVO: CARACTERÍSTICAS CLÍNICAS Y DESFECHOSRESUMEN: Estudio cuantitativo, documental, retrospectivo, con objeto de caracterizar el perfil clínico-demográfico y el desfecho de pacientes con insuficiencia renal, sometidos a la terapia dialítica en una unidad de terapia intensiva adulto de un hospital general de la región sur de Brasil. Los datos fueron recolectados en enero y febrero del 2013 y la muestra incluyó a 74 archivos. Fue identificada prevalencia del sexo masculino, edad media 63,43 ± 14,73 años, el motivo clínico fue el más frecuente para internación, con una o más comorbilidades asociadas. La lesión renal con mayor prevalencia fue la crónica agudizada, pre-renal. Respecto a los motivos de la lesión, el choque séptico fue el más recurrente. El desfecho más común fue el óbito. Así, la identificación de factores de riesgo y el conocimiento de los factores asociadosapoyan la rápida identificación de problemas y la implementación de acciones de enfermería.

show abstract

A European Renal Best Practice (ERBP) position statement on the Kidney Disease Improving Global Outcomes (KDIGO) Clinical Practice Guidelines on Acute Kidney Injury: Part 1: definitions, conservative management and contrast-induced nephropathy

Cited by 479 publications

References 72 publications

Acute Respiratory Distress Syndrome and Risk of AKI among Critically Ill Patients

Acute Respiratory Distress Syndrome and Risk of AKI among Critically Ill Patients

Incidence, Outcomes, and Comparisons across Definitions of AKI in Hospitalized Individuals

Lesão Renal Aguda Em Unidade De Tratamento Intensivo: Características Clínicas E Desfechos

Contact Info

Product

Resources

About